The Medicare Prescription Drug Rebate Rule

PCMA Urges Congress to Permanently Repeal Rebate Rule This Year

The Medicare Part D prescription drug benefit provides our nation’s seniors with affordable drug coverage, which is more important now than ever.

The rebate rule clumsily attempts to eliminate the primary tool used by pharmacy benefit managers, or PBMs, to negotiate increased access to affordable prescription drugs with drug manufacturers.

The rule would not reduce drug costs: Centers for Medicare and Medicaid Services actuaries and the Congressional Budget Office have said it would significantly increase Medicare Part D premiums and add $170 billion in Part D program costs for taxpayers.

Congress should permanently repeal the rebate rule and advance real solutions that protect seniors while bringing down the costs of prescription drugs.

Letter to Congress from organizations working to protect seniors
and maintain affordable access to prescription drugs

“We believe it is imperative to block implementation of this rule to
protect Medicare beneficiaries and taxpayers from unsustainable cost increases.”

Medicare Premiums Will Increase an Additional $56 Billion Over 10
Years With Adoption of the HHS “Rebate Rule”

When Medicare Premiums Rise, Beneficiaries in All States Pay More

Methodology: The Health and Human Services (HHS) Office of the Actuary (OACT) estimated that adoption of the HHS “Rebate Rule” would cause Medicare premiums to rise $56 billion over the 10-year period 2020-2029. That 10-year premium impact was apportioned across the 50 states and the District of Columbia using 2018 Part D enrollment.

Sources:
HHS OACT “Proposed Safe Harbor Regulation.”
Kaiser Family Foundation “Medicare Beneficiaries Enrolled in Part D Coverage (2018).”

OUR PODCASt

RESEARCH

State Health Plans Use Drug Rebates to Lower Premiums and Enhance Benefits

Read the results from the new Public Sector Healthcare Roundtable Survey…

Keep Reading >

National Online Survey of Seniors Regarding the Medicare Part D Prescription Drug Benefit

In collaboration with North Start Opinion Research, PCMA conducted an online on December 17-20, 2020 with 800 respondents…

Keep Reading >

Impact of Medicare Part D Drug Manufacturer Rebates at the Point-of-Sale

A new report by Milliman shows that over the 10-year period 2022-2031, if all manufacturer rebates were reflected at the…

Keep Reading >

OP-EDS & PRESS RELEASES

Morning Consult: Congress Should Act Quickly to Permanently Repeal the Rebate Rule April 12, 2021 While Congress and the Biden administration, as well as stakeholders across the prescription drug supply chain, examine policy options for addressing high drug prices, pharmacy benefit managers continue… Keep Reading >

PCMA Launches New Campaign Aimed At Repealing the Medicare Prescription Drug Rebate Rule

March 1, 2021

(Washington, D.C.) — The Pharmaceutical Care Management Association (PCMA) unveiled a new campaign commending the Biden Administration for delaying the Medicare prescription drug rebate rule…

Keep Reading >

Rebate Rule Effective Date Postponed to 2023

January 30, 2021

(Washington, D.C.) — In response to litigation brought by the Pharmaceutical Care Management Association (PCMA) challenging the Medicare Part D rebate…

Keep Reading >

The Hill: The path forward for the Biden administration: Lowering drug costs without raising premiums for seniors

January 27, 2021

The new Biden administration has started off strong, taking a thoughtful approach to any number of critical health care issues… Keep Reading >

PCMA Files Motion to Vacate Effective Date for Rebate Rule

January 26, 2021

(Washington, D.C.) — The Pharmaceutical Care Management Association (PCMA) has filed a motion for summary judgment to vacate the effective…

Keep Reading >

PCMA Federal Policy Priorities: 21 Policies to Reduce Prescription Drug Costs in 2021

January 14, 2021

(Washington, D.C.) — The Pharmaceutical Care Management Association (PCMA) today issued 21 policy solutions supported by America’s pharmacy benefit managers (PBMs) aimed at reducing prescription…

Keep Reading >

PCMA Files Lawsuit Challenging Rebate Rule

January 12, 2021

(Washington, D.C.) — The Pharmaceutical Care Management Association (PCMA) today filed a lawsuit challenging the Trump Administration’s rebate rule. PCMA’s…

Keep Reading >

PCMA: Pharmacy Benefit Managers Ready to Work with the New Administration to Lower Prescription Costs

November 07, 2020

Keep Reading >

Pharmacy Benefit Managers Continue to Keep Medicare Part D Premiums Affordable

October 16, 2020

(Washington, D.C.) — Pharmaceutical Care Management Association President and CEO JC Scott issued the following statement on the open enrollment season for the…

Keep Reading >

New Report Confirms Proposed “Rebate Rule” Would Raise Medicare Premiums and Taxpayer Costs

September 08, 2020

(Washington, D.C.) — A new report, “Negative Economic Impact of Restricting Rebates in Medicare Part D,” by Alex Brill of…

Keep Reading >